Shopko Stores Operating Co. Llc in Fond Du Lac - Eyewear Supplier
Shopko Stores Operating Co. Llc - NPI 1013960723
Shopko Stores Operating Co. Llc is a Eyewear Supplier in Fond Du Lac, Wisconsin. Shopko Stores Operating Co. Llc practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for Shopko Stores Operating Co. Llc is 1013960723. The last update date is 2008-02-11.
Shopko Stores Operating Co. Llc's current location address is 616 W Johnson St, Fond Du Lac, Wisconsin. You can contact this provider via phone number 9209218290. The mailing address for Shopko Stores Operating Co. Llc is 616 W Johnson St, Fond Du Lac, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shopko Stores Operating Co. Llc |
|---|---|
| Address | 616 W Johnson St, Fond Du Lac, Wisconsin |
| Phone Number | 9209218290 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SR. VICE P |
|---|---|
| Authorized Official Name | Bettiga J Michael |
| Credentials | RPH |
| Telephone Number | 9204294297 |
NPI Number Detail
| NPI Number | 1013960723 |
|---|---|
| Provider Enumeration Date | 2006-05-17 |
| Last Updated Date | 2008-02-11 |
Provider Mailing Address Detail
| Address | 616 W Johnson St |
|---|---|
| City | Fond Du Lac |
| State | Wisconsin (WI) |
| Post Code | 549353134 |
| Phone Number | 9209218290 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
|
Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 14050 | VIP | ||
| 410985054-4050 | NVA | ||
| 17654 | MEDICARE | ||
| 35560 | AVESIS | ||
| CP2230-3 | EYEMED | ||
| 38426900 | WI | -- | |
| 42597 | DAVIS |
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What is the unique identification code assigned to Shopko Stores Operating Co. Llc by the Centers for Medicare & Medicaid Services?
The Shopko Stores Operating Co. Llc has been issued the NPI (National Provider Identifier) 1013960723. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Shopko Stores Operating Co. Llc located?
The Shopko Stores Operating Co. Llc is located at 616 W Johnson St, Fond Du Lac, WI 549353134.
What is Shopko Stores Operating Co. Llc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Shopko Stores Operating Co. Llc is Eyewear Supplier, and the taxonomy code that categorizes this field of expertise is 332H00000X.
When did Shopko Stores Operating Co. Llc receive its 1013960723 assignment?
The Shopko Stores Operating Co. Llc was assigned its 1013960723 on 2006-05-17, which is the date when this unique identifier was issued to the organization.
As of what date were the details related to Shopko Stores Operating Co. Llc most recently updated or revised?
The information pertaining to Shopko Stores Operating Co. Llc, including its address, specialty, and other relevant details, was last updated or revised on 2008-02-11.